Psychologische Grundlagen der pädiatrischen Lebertransplantation

Zusammenfassung

Die Lebertransplantation (LTX) ist ein etabliertes Therapieverfahren für pädiatrische Patienten mit Leberversagen. Dabei sind die Überlebensraten in den letzten Jahrzehnten kontinuierlich gestiegen. Mit der Anzahl gewonnener Lebensjahre rückt die Frage nach deren Qualität in den Vordergrund. Dieser Artikel gibt einen Überblick über die Aufgabenfelder der pädiatrischen Transplantationspsychologie. Es werden Forschungsergebnisse zur gesundheitsbezogenen Lebensqualität von lebertransplantierten Kindern und Jugendlichen sowie zu Fatigue, zur psychischen Gesundheit, zur kognitiven Entwicklung und zu familiären Belastungen vorgestellt. Im Jugend- und jungem Erwachsenenalter ist das Risiko für Non-Adhärenz besonders hoch. Daher werden Adhärenz und Transition, das heißt der Wechsel in die Erwachsenenmedizin, gesondert diskutiert sowie Studien zum Langzeitüberleben nach LTX vorgestellt. Empfehlungen für die klinische Praxis bilden den Abschluss.

Abstract

Liver transplantation (LTX) is an established therapy for pediatric patients with liver failure. In recent decades, survival rates have risen continuously. With increased life expectancy, there has been greater attention to children’s and adolescents’ quality of life following transplantation. This article provides an overview of the tasks of pediatric transplant psychology. We summarize the reviewed literature of research on health-related quality of life in pediatric liver transplant recipients. Furthermore, we present studies on fatigue, mental health, cognitive development and family strain. In adolescents and young adults, the risk of non-adherence is particularly high. Therefore, adherence and transition, i. e. transfer from pediatric to adult-centered transplant care, are discussed separately. Subsequently, studies on long-term survival after LTX are summarized. In conclusion, recommendations for clinical practice are given.

Schlüsselwörter

Transplantationspsychologie - pädiatrische Lebertransplatation - gesundheitsbezogene Lebensqualität - psychische Gesundheit - kognitive Entwicklung

Key words

transplant psychology - pediatric liver transplantation - health-related quality of life - mental health - cognitive development

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